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Huang Q, Chu Z, Wang Z, Li Q, Meng S, Lu Y, Ma K, Cui S, Hu W, Zhang W, Wei Q, Qu Y, Li H, Fu X, Zhang C. circCDK13-loaded small extracellular vesicles accelerate healing in preclinical diabetic wound models. Nat Commun 2024; 15:3904. [PMID: 38724502 PMCID: PMC11082226 DOI: 10.1038/s41467-024-48284-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 04/25/2024] [Indexed: 05/12/2024] Open
Abstract
Chronic wounds are a major complication in patients with diabetes. Here, we identify a therapeutic circRNA and load it into small extracellular vesicles (sEVs) to treat diabetic wounds in preclinical models. We show that circCDK13 can stimulate the proliferation and migration of human dermal fibroblasts and human epidermal keratinocytes by interacting with insulin-like growth factor 2 mRNA binding protein 3 in an N6-Methyladenosine-dependent manner to enhance CD44 and c-MYC expression. We engineered sEVs that overexpress circCDK13 and show that local subcutaneous injection into male db/db diabetic mouse wounds and wounds of streptozotocin-induced type I male diabetic rats could accelerate wound healing and skin appendage regeneration. Our study demonstrates that the delivery of circCDK13 in sEVs may present an option for diabetic wound treatment.
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Affiliation(s)
- Qilin Huang
- Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital, 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Ziqiang Chu
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital, 51 Fucheng Road, Haidian District, Beijing, 100048, China
- Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences, 2019RU051, 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Zihao Wang
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital, 51 Fucheng Road, Haidian District, Beijing, 100048, China
- Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences, 2019RU051, 51 Fucheng Road, Haidian District, Beijing, 100048, China
- Chinese PLA Medical School, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Qiankun Li
- Department of Tissue Repair and Regeneration, The First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Sheng Meng
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital, 51 Fucheng Road, Haidian District, Beijing, 100048, China
- Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences, 2019RU051, 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Yao Lu
- Department of Tissue Repair and Regeneration, The First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Kui Ma
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital, 51 Fucheng Road, Haidian District, Beijing, 100048, China
- Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences, 2019RU051, 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Shengnan Cui
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital, 51 Fucheng Road, Haidian District, Beijing, 100048, China
- Department of Dermatology, China Academy of Chinese Medical Science, Xiyuan Hospital, Beijing, 100091, China
| | - Wenzhi Hu
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital, 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Wenhua Zhang
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital, 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Qian Wei
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital, 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Yanlin Qu
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital, 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Haihong Li
- Department of Burns and Plastic Surgery, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong Province, 518055, China.
| | - Xiaobing Fu
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital, 51 Fucheng Road, Haidian District, Beijing, 100048, China.
- Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences, 2019RU051, 51 Fucheng Road, Haidian District, Beijing, 100048, China.
- PLA Key Laboratory of Tissue Repair and Regenerative Medicine and Beijing Key Research Laboratory of Skin Injury, Repair and Regeneration, 51 Fucheng Road, Haidian District, Beijing, 100048, China.
- Innovation Center for Wound Repair, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, China.
| | - Cuiping Zhang
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department, PLA General Hospital, 51 Fucheng Road, Haidian District, Beijing, 100048, China.
- Research Unit of Trauma Care, Tissue Repair and Regeneration, Chinese Academy of Medical Sciences, 2019RU051, 51 Fucheng Road, Haidian District, Beijing, 100048, China.
- PLA Key Laboratory of Tissue Repair and Regenerative Medicine and Beijing Key Research Laboratory of Skin Injury, Repair and Regeneration, 51 Fucheng Road, Haidian District, Beijing, 100048, China.
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2
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Baccouche BM, Elde S, Wang H, Woo YJ. Structural, angiogenic, and immune responses influencing myocardial regeneration: a glimpse into the crucible. NPJ Regen Med 2024; 9:18. [PMID: 38688935 PMCID: PMC11061134 DOI: 10.1038/s41536-024-00357-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 03/15/2024] [Indexed: 05/02/2024] Open
Abstract
Complete cardiac regeneration remains an elusive therapeutic goal. Although much attention has been focused on cardiomyocyte proliferation, especially in neonatal mammals, recent investigations have unearthed mechanisms by which non-cardiomyocytes, such as endothelial cells, fibroblasts, macrophages, and other immune cells, play critical roles in modulating the regenerative capacity of the injured heart. The degree to which each of these cell types influence cardiac regeneration, however, remains incompletely understood. This review highlights the roles of these non-cardiomyocytes and their respective contributions to cardiac regeneration, with emphasis on natural heart regeneration after cardiac injury during the neonatal period.
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Affiliation(s)
- Basil M Baccouche
- Stanford University Department of Cardiothoracic Surgery, Palo Alto, CA, USA
| | - Stefan Elde
- Stanford University Department of Cardiothoracic Surgery, Palo Alto, CA, USA
| | - Hanjay Wang
- Stanford University Department of Cardiothoracic Surgery, Palo Alto, CA, USA
| | - Y Joseph Woo
- Stanford University Department of Cardiothoracic Surgery, Palo Alto, CA, USA.
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3
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Bydon M, Qu W, Moinuddin FM, Hunt CL, Garlanger KL, Reeves RK, Windebank AJ, Zhao KD, Jarrah R, Trammell BC, El Sammak S, Michalopoulos GD, Katsos K, Graepel SP, Seidel-Miller KL, Beck LA, Laughlin RS, Dietz AB. Intrathecal delivery of adipose-derived mesenchymal stem cells in traumatic spinal cord injury: Phase I trial. Nat Commun 2024; 15:2201. [PMID: 38561341 PMCID: PMC10984970 DOI: 10.1038/s41467-024-46259-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 02/21/2024] [Indexed: 04/04/2024] Open
Abstract
Intrathecal delivery of autologous culture-expanded adipose tissue-derived mesenchymal stem cells (AD-MSC) could be utilized to treat traumatic spinal cord injury (SCI). This Phase I trial (ClinicalTrials.gov: NCT03308565) included 10 patients with American Spinal Injury Association Impairment Scale (AIS) grade A or B at the time of injury. The study's primary outcome was the safety profile, as captured by the nature and frequency of adverse events. Secondary outcomes included changes in sensory and motor scores, imaging, cerebrospinal fluid markers, and somatosensory evoked potentials. The manufacturing and delivery of the regimen were successful for all patients. The most commonly reported adverse events were headache and musculoskeletal pain, observed in 8 patients. No serious AEs were observed. At final follow-up, seven patients demonstrated improvement in AIS grade from the time of injection. In conclusion, the study met the primary endpoint, demonstrating that AD-MSC harvesting and administration were well-tolerated in patients with traumatic SCI.
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Affiliation(s)
- Mohamad Bydon
- Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA.
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA.
| | - Wenchun Qu
- Physical Medicine and Rehabilitation, Mayo Clinic, Jacksonville, FL, USA
| | - F M Moinuddin
- Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA
| | | | | | - Ronald K Reeves
- Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | | | - Kristin D Zhao
- Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | - Ryan Jarrah
- Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA
| | - Brandon C Trammell
- Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA
| | - Sally El Sammak
- Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA
| | - Giorgos D Michalopoulos
- Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA
| | - Konstantinos Katsos
- Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA
| | | | | | - Lisa A Beck
- Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | | | - Allan B Dietz
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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4
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Beksac M, Eikema DJ, Koster L, Hulin C, Poiré X, Hamladji RM, Gromek T, Bazarbachi A, Ozkurt ZN, Pabst T, Ben Othman T, Finke J, Pirogova O, Wu D, Hayat A, Hilgendorf I, Tholouli E, de Wreede LC, Schönland S, Garderet L, Drozd-Sokolowska J, Raj K, Hayden PJ, Yakoub-Agha I, McLornan DP. In the era of Bortezomib-based Induction, intensification of Melphalan-based conditioning with Bortezomib does not improve Survival Outcomes in newly diagnosed Multiple Myeloma: a study from the Chronic Malignancies Working Party of the EBMT. Bone Marrow Transplant 2024; 59:526-533. [PMID: 38297040 PMCID: PMC10994834 DOI: 10.1038/s41409-023-02160-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/03/2023] [Accepted: 11/21/2023] [Indexed: 02/02/2024]
Abstract
Bortezomib (Vel)- Melphalan 200 mg/m2 (Mel200) (Vel-Mel) has been utilised to intensify conditioning in autologous hematopoietic stem cell transplantation (AHCT) for multiple myeloma (MM). This EBMT registry-based study compared Vel-Mel with Mel200 during upfront AHCT. Between 2010 and 2017, MM patients who received Vel-Mel (n = 292) conditioning were compared with 4,096 Mel200 patients in the same 58 centres. Pre-AHCT, compared to Mel200 patients, Vel-Mel patients had similar International Staging System (ISS) scores and cytogenetic risk profiles; a similar proportion had received bortezomib-based induction (85% and 87.3%, respectively) though they were younger with a better performance status. Vel-Mel patients were more likely to achieve CR post-induction (40.6% vs 20.3%, p < 0.001) and by day 100 of AHCT (CR/VGPR: 70.2 % vs. 57.2%, p < 0.001). There was no difference in 3-year PFS (49% vs 46%, p = 0.06) or early post-AHCT mortality. In multivariable analysis, Vel-Mel associated with inferior PFS (HR: 1.69 (1.27-2.25, p < 0.001) and OS (HR:1.46 (1.14-1.86,p = 0.002), similar to negative effects on PFS of advanced ISS (HR:1.56 (1.33-1.83, p < 0.001), high-risk cytogenetics (HR:1.43(1.18-1.74, p < 0.001) and poor post-induction response(<=PR)(HR: 1.43(1.25-1.62, p < 0.001) Overall, despite superior pre- and post-AHCT responses, there was no improvement in PFS or OS following Vel-Mel. This data supports the findings of the smaller prospective IFM study.
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Affiliation(s)
- Meral Beksac
- Istinye University Ankara Liv Hospital Hematology and Stem Cell Transplantation Unit, Ankara, 06880, Turkey.
| | | | | | | | - Xavier Poiré
- Cliniques Universitaires St. Luc, Brussels, Belgium
| | | | | | - Ali Bazarbachi
- Bone Marrow Transplantation Program, American University of Beirut Medical Center, Beiruit, Lebanon
| | | | | | | | | | - Olga Pirogova
- RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russian Federation
| | - Depei Wu
- First Affiliated Hospital of Soochow University, Suzhou, China
| | - Amjad Hayat
- The Blood and Tissue Establishment, Galway University Hospital, Galway, Ireland
| | | | | | - Liesbeth C de Wreede
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Stefan Schönland
- Medizinische Klinik u. Poliklinik V, University of Heidelberg, Heidelberg, Germany
| | | | | | - Kavita Raj
- Department of Stem Cell Transplantation, University College London Hospitals, London, UK
| | - Patrick J Hayden
- Department of Haematology, Trinity College Dublin, St. James's Hospital, Dublin, Ireland
| | | | - Donal P McLornan
- Department of Stem Cell Transplantation, University College London Hospitals, London, UK
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5
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Chu H, Zhang S, Zhang Z, Yue H, Liu H, Li B, Yin F. Comparison studies identify mesenchymal stromal cells with potent regenerative activity in osteoarthritis treatment. NPJ Regen Med 2024; 9:14. [PMID: 38561335 PMCID: PMC10984924 DOI: 10.1038/s41536-024-00358-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024] Open
Abstract
Osteoarthritis affects 15% of people over 65 years of age. It is characterized by articular cartilage degradation and inflammation, leading to joint pain and disability. Osteoarthritis is incurable and the patients may eventually need joint replacement. An emerging treatment is mesenchymal stromal cells (MSCs), with over two hundred clinical trials being registered. However, the outcomes of these trials have fallen short of the expectation, due to heterogeneity of MSCs and uncertain mechanisms of action. It is generally believed that MSCs exert their function mainly by secreting immunomodulatory and trophic factors. Here we used knee osteoarthritis mouse model to assess the therapeutic effects of MSCs isolated from the white adipose or dermal adipose tissue of Prrx1-Cre; R26tdTomato mice and Dermo1-Cre; R26tdTomato mice. We found that the Prrx1-lineage MSCs from the white adipose tissues showed the greatest in vitro differentiation potentials among the four MSC groups and single cell profiling showed that the Prrx1-lineage MSCs contained more stem cells than the Dermo1 counterpart. Only the Prrx1-lineage cells isolated from white adipose tissues showed long-term therapeutic effectiveness on early-stage osteoarthritis models. Mechanistically, Prrx1-lineage MSCs differentiated into Col2+ chondrocytes and replaced the damage cartilage, activated Col1 expressing in resident chondrocytes, and inhibited synovial inflammation. Transcriptome analysis showed that the articular chondrocytes derived from injected MSCs expressed immunomodulatory cytokines, trophic factors, and chondrocyte-specific genes. Our study identified a MSC population genetically marked by Prrx1 that has great multipotentiality and can differentiate into chondrocytes to replace the damaged cartilage.
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Affiliation(s)
- Hongshang Chu
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Shaoyang Zhang
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Zhenlin Zhang
- Department of Osteoporosis and Bone Diseases, Shanghai Clinical Research Center of Bone Disease, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Hua Yue
- Department of Osteoporosis and Bone Diseases, Shanghai Clinical Research Center of Bone Disease, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Huijuan Liu
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Baojie Li
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, 200240, China.
- Shanghai Institute of Stem Cell Research and Clinical Translation, Shanghai, 200120, China.
| | - Feng Yin
- Shanghai Institute of Stem Cell Research and Clinical Translation, Shanghai, 200120, China.
- Translational Medical Center for Stem Cell Therapy, Shanghai East Hospital, Tongji University, Shanghai, 200120, China.
- Department of Joint and Sports Medicine, East Hospital, Tongji University School of Medicine, Shanghai, 200092, China.
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6
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Pan W, Rahman AA, Ohkura T, Stavely R, Ohishi K, Han CY, Leavitt A, Kashiwagi A, Burns AJ, Goldstein AM, Hotta R. Autologous cell transplantation for treatment of colorectal aganglionosis in mice. Nat Commun 2024; 15:2479. [PMID: 38509106 PMCID: PMC10954649 DOI: 10.1038/s41467-024-46793-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/11/2024] [Indexed: 03/22/2024] Open
Abstract
Neurointestinal diseases cause significant morbidity and effective treatments are lacking. This study aimes to test the feasibility of transplanting autologous enteric neural stem cells (ENSCs) to rescue the enteric nervous system (ENS) in a model of colonic aganglionosis. ENSCs are isolated from a segment of small intestine from Wnt1::Cre;R26iDTR mice in which focal colonic aganglionosis is simultaneously created by diphtheria toxin injection. Autologous ENSCs are isolated, expanded, labeled with lentiviral-GFP, and transplanted into the aganglionic segment in vivo. ENSCs differentiate into neurons and glia, cluster to form neo-ganglia, and restore colonic contractile activity as shown by electrical field stimulation and optogenetics. Using a non-lethal model of colonic aganglionosis, our results demonstrate the potential of autologous ENSC therapy to improve functional outcomes in neurointestinal disease, laying the groundwork for clinical application of this regenerative cell-based approach.
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Affiliation(s)
- Weikang Pan
- Department of Pediatric Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Pediatric Surgery, The second affiliated hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ahmed A Rahman
- Department of Pediatric Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Takahiro Ohkura
- Department of Pediatric Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rhian Stavely
- Department of Pediatric Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kensuke Ohishi
- Department of Pediatric Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Drug Discovery Laboratory, Wakunaga Pharmaceutical Co., Ltd., Hiroshima, Japan
| | - Christopher Y Han
- Department of Pediatric Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Abigail Leavitt
- Department of Pediatric Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Aki Kashiwagi
- Department of Pediatric Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alan J Burns
- Department of Pediatric Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Stem Cells and Regenerative Medicine, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Allan M Goldstein
- Department of Pediatric Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ryo Hotta
- Department of Pediatric Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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7
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Maze D, Arcasoy MO, Henrie R, Cerquozzi S, Kamble R, Al-Hadidi S, Yacoub A, Singh AK, Elsawy M, Sirhan S, Smith E, Marcoux C, Viswabandya A, Daly A, Sibai H, McNamara C, Shi Y, Xu W, Lajkosz K, Foltz L, Gupta V. Upfront allogeneic transplantation versus JAK inhibitor therapy for patients with myelofibrosis: a North American collaborative study. Bone Marrow Transplant 2024; 59:196-202. [PMID: 37938736 PMCID: PMC10849956 DOI: 10.1038/s41409-023-02146-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/19/2023] [Accepted: 10/30/2023] [Indexed: 11/09/2023]
Abstract
Allogeneic hematopoietic cell transplantation (HCT) is the only curative therapy for myelofibrosis (MF) and is recommended for patients with higher risk disease. However, there is a risk of early mortality, and optimal timing is unknown. JAK inhibitor (JAKi) therapy may offer durable improvement in symptoms, splenomegaly and quality of life. The aim of this multicentre, retrospective observational study was to compare outcomes of patients aged 70 years or below with MF in chronic phase who received upfront JAKi therapy vs. upfront HCT in dynamic international prognostic scoring system (DIPSS)-stratified categories. For the whole study cohort, median overall survival (OS) was longer for patients who received a JAKi vs. upfront HCT, 69 (95% CI 57-89) vs. 42 (95% CI 20-not reached, NR) months, respectively (p = 0.01). In patients with intermediate-2 and high-risk disease, median OS was 55 (95% CI 36-73) months with JAKi vs. 36 (95% CI 20-NR) months for HCT (p = 0.27). An upfront HCT strategy was associated with early mortality and difference in median OS was not observed in any risk group by 5 years of follow-up. Within the limitations of a retrospective observational study, we did not observe any benefit of a universal upfront HCT approach for higher-risk MF.
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Affiliation(s)
- Dawn Maze
- The Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
| | - Murat O Arcasoy
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA
| | - Ryan Henrie
- Division of Hematology, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Sonia Cerquozzi
- Tom Baker Cancer Centre, Alberta Health Service Calgary Zone, University of Calgary, Calgary, AB, Canada
| | - Rammurti Kamble
- Center for Cell and Gene Therapy, Baylor College of Medicine and Houston Methodist Hospital, Houston, TX, USA
| | - Samer Al-Hadidi
- Myeloma Section, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Abdulraheem Yacoub
- Division of Hematology and Oncology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Anurag K Singh
- Division of Hematology and Oncology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Mahmoud Elsawy
- Division of Hematology, Dalhousie University, Halifax, NS, Canada
| | - Shireen Sirhan
- Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Elliot Smith
- The Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Curtis Marcoux
- Division of Hematology, Dalhousie University, Halifax, NS, Canada
| | - Auro Viswabandya
- The Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Andrew Daly
- Tom Baker Cancer Centre, Alberta Health Service Calgary Zone, University of Calgary, Calgary, AB, Canada
| | - Hassan Sibai
- The Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Caroline McNamara
- The Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Yuliang Shi
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
| | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Katherine Lajkosz
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lynda Foltz
- Division of Hematology, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Vikas Gupta
- The Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
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8
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Maze D, Arcasoy MO, Henrie R, Cerquozzi S, Kamble R, Al-Hadidi S, Yacoub A, Singh AK, Elsawy M, Sirhan S, Smith E, Marcoux C, Viswabandya A, Daly A, Sibai H, McNamara C, Shi Y, Xu W, Lajkosz K, Foltz L, Gupta V. Correction: Upfront allogeneic transplantation versus JAK inhibitor therapy for patients with myelofibrosis: a North American collaborative study. Bone Marrow Transplant 2024; 59:295. [PMID: 38279008 PMCID: PMC10849954 DOI: 10.1038/s41409-023-02194-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Affiliation(s)
- Dawn Maze
- The Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
| | - Murat O Arcasoy
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA
| | - Ryan Henrie
- Division of Hematology, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Sonia Cerquozzi
- Tom Baker Cancer Centre, Alberta Health Service Calgary Zone, University of Calgary, Calgary, AB, Canada
| | - Rammurti Kamble
- Center for Cell and Gene Therapy, Baylor College of Medicine and Houston Methodist Hospital, Houston, TX, USA
| | - Samer Al-Hadidi
- Myeloma Section, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Abdulraheem Yacoub
- Division of Hematology and Oncology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Anurag K Singh
- Division of Hematology and Oncology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Mahmoud Elsawy
- Division of Hematology, Dalhousie University, Halifax, NS, Canada
| | - Shireen Sirhan
- Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Elliot Smith
- The Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Curtis Marcoux
- Division of Hematology, Dalhousie University, Halifax, NS, Canada
| | - Auro Viswabandya
- The Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Andrew Daly
- Tom Baker Cancer Centre, Alberta Health Service Calgary Zone, University of Calgary, Calgary, AB, Canada
| | - Hassan Sibai
- The Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Caroline McNamara
- The Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Yuliang Shi
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
| | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Katherine Lajkosz
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lynda Foltz
- Division of Hematology, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Vikas Gupta
- The Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
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9
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Derraz B, Breda G, Kaempf C, Baenke F, Cotte F, Reiche K, Köhl U, Kather JN, Eskenazy D, Gilbert S. New regulatory thinking is needed for AI-based personalised drug and cell therapies in precision oncology. NPJ Precis Oncol 2024; 8:23. [PMID: 38291217 PMCID: PMC10828509 DOI: 10.1038/s41698-024-00517-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/06/2024] [Indexed: 02/01/2024] Open
Abstract
Until recently the application of artificial intelligence (AI) in precision oncology was confined to activities in drug development and had limited impact on the personalisation of therapy. Now, a number of approaches have been proposed for the personalisation of drug and cell therapies with AI applied to therapy design, planning and delivery at the patient's bedside. Some drug and cell-based therapies are already tuneable to the individual to optimise efficacy, to reduce toxicity, to adapt the dosing regime, to design combination therapy approaches and, preclinically, even to personalise the receptor design of cell therapies. Developments in AI-based healthcare are accelerating through the adoption of foundation models, and generalist medical AI models have been proposed. The application of these approaches in therapy design is already being explored and realistic short-term advances include the application to the personalised design and delivery of drugs and cell therapies. With this pace of development, the limiting step to adoption will likely be the capacity and appropriateness of regulatory frameworks. This article explores emerging concepts and new ideas for the regulation of AI-enabled personalised cancer therapies in the context of existing and in development governance frameworks.
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Affiliation(s)
- Bouchra Derraz
- ProductLife Group, Paris, France
- Groupe de recherche et d'accueil en droit et économie de la santé (GRADES), Faculty of Pharmacy, University Paris-Saclay, Paris, France
| | | | - Christoph Kaempf
- Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
| | - Franziska Baenke
- Carl Gustav Carus University Hospital Dresden, Dresden University of Technology, Dresden, Germany
| | - Fabienne Cotte
- Department of Emergency Medicine, University Clinic Marburg, Philipps-University, Marburg, Germany
| | - Kristin Reiche
- Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
- Center for Scalable Data Analytics and Artificial Intelligence (ScaDS.AI), Dresden/Leipzig, Germany
- Institute of Clinical Immunology, University Leipzig, Leipzig, Germany
| | - Ulrike Köhl
- Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
- Institute of Clinical Immunology, University Leipzig, Leipzig, Germany
| | - Jakob Nikolas Kather
- Carl Gustav Carus University Hospital Dresden, Dresden University of Technology, Dresden, Germany
- Else Kröner Fresenius Center for Digital Health, TUD Dresden University of Technology, Dresden, Germany
| | - Deborah Eskenazy
- Groupe de recherche et d'accueil en droit et économie de la santé (GRADES), Faculty of Pharmacy, University Paris-Saclay, Paris, France
| | - Stephen Gilbert
- Carl Gustav Carus University Hospital Dresden, Dresden University of Technology, Dresden, Germany.
- Else Kröner Fresenius Center for Digital Health, TUD Dresden University of Technology, Dresden, Germany.
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10
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Strouse C, Mott SL, Smith BJ, Magalhaes-Silverman M, Farooq U, Zhan F, Jethava Y, Tricot G. Transplant conditioning with bortezomib, thalidomide, and melphalan and intensive 2 year post-transplant therapy for multiple myeloma in older patients. Bone Marrow Transplant 2024; 59:128-130. [PMID: 37816907 PMCID: PMC10781621 DOI: 10.1038/s41409-023-02119-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/14/2023] [Accepted: 09/26/2023] [Indexed: 10/12/2023]
Affiliation(s)
- Christopher Strouse
- Division of Hematology, Oncology, and Blood & Marrow Transplantation, University of Iowa, Iowa City, IA, USA.
| | - Sarah L Mott
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
| | - Brian J Smith
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
| | | | - Umar Farooq
- Division of Hematology, Oncology, and Blood & Marrow Transplantation, University of Iowa, Iowa City, IA, USA
| | - Fenghuang Zhan
- Winthrop P. Rockefeller Cancer Institute, University of Arkansas Medical Center, Little Rock, AK, USA
| | - Yogesh Jethava
- Indiana Blood & Marrow Transplant, Indianapolis, IN, USA
| | - Guido Tricot
- Winthrop P. Rockefeller Cancer Institute, University of Arkansas Medical Center, Little Rock, AK, USA
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11
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Cancio M, Troullioud Lucas AG, Bierings M, Klein E, de Witte MA, Smiers FJ, Bresters D, Boelens JJ, Smetsers SE. Predictors of outcomes in hematopoietic cell transplantation for Fanconi anemia. Bone Marrow Transplant 2024; 59:34-40. [PMID: 37848556 PMCID: PMC10781622 DOI: 10.1038/s41409-023-02121-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 09/16/2023] [Accepted: 10/04/2023] [Indexed: 10/19/2023]
Abstract
Allogeneic hematopoietic cell transplantation (HCT) remains the only cure for the hematologic manifestations of Fanconi anemia (FA). We performed retrospective predictor analyses for HCT outcomes in FA for pediatric and young adult patients transplanted between 2007 and 2020 across three large referral institutions. Eighty-nine patients, 70 with bone marrow failure +/- cytogenetic abnormalities, 19 with MDS/AML, were included. Five-year overall survival (OS) was 83.2% and event-free survival (EFS) was 74%. Age ≥19, HLA mismatch and year of HCT were multivariable predictors (MVPs) for OS, EFS and treatment-related mortality (TRM). In the pediatric group, TCD was a borderline MVP (P = 0.059) with 5-year OS of 73.0% in TCD vs. 100% for T-replete HCT. The cumulative incidence of day 100 grade II-IV aGvHD and 5-year cGvHD were 5.6% and 4.6%, respectively. Relapse in the MDS/AML subgroup occurred in 4 patients (16%). Graft failure was seen in 9 patients (TCD 6/37 [16%]; T-replete 3/52 [5.7%]). Six patients developed malignancy after HCT. Survival chances after HCT for FA are excellent and associated with high engrafted survival and low toxicity. Age ≥19, HLA mismatch, year of transplant and 'TCD in the <19 years group' (although borderline) were found to be negative predictors for survival.
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Affiliation(s)
- Maria Cancio
- Transplantation and Cellular Therapy, MSK Kids, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Alexandre G Troullioud Lucas
- Transplantation and Cellular Therapy, MSK Kids, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Marc Bierings
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Pediatric Oncology/Hematology, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, the Netherlands
| | - Elizabeth Klein
- Transplantation and Cellular Therapy, MSK Kids, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Moniek A de Witte
- Department of Hematology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Frans J Smiers
- Department of Pediatric Hematology and Stem Cell Transplantation, Willem Alexander Children's Hospital/Leiden University Medical Center, Leiden, the Netherlands
| | - Dorine Bresters
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Pediatric Hematology and Stem Cell Transplantation, Willem Alexander Children's Hospital/Leiden University Medical Center, Leiden, the Netherlands
| | - Jaap Jan Boelens
- Transplantation and Cellular Therapy, MSK Kids, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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12
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Mozaffari Jovein M, Ihorst G, Duque-Afonso J, Wäsch R, Bertz H, Wehr C, Duyster J, Zeiser R, Finke J, Scherer F. Long-term follow-up of patients with acute myeloid leukemia undergoing allogeneic hematopoietic stem cell transplantation after primary induction failure. Blood Cancer J 2023; 13:179. [PMID: 38071327 PMCID: PMC10710471 DOI: 10.1038/s41408-023-00953-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
Primary induction failure (PIF) in acute myeloid leukemia (AML) patients is associated with poor outcome, with allogeneic hematopoietic stem cell transplantation (HCT) being the sole curative therapeutic option. Here, we retrospectively evaluated long-term outcomes of 220 AML patients undergoing allogeneic HCT after PIF who never achieved remission, and identified clinical and molecular risk factors associated with treatment response and ultimate prognosis. In this high-risk population, disease-free survival was 25.2% after 5 years and 18.7% after 10 years, while overall survival rates were 29.8% and 21.6% after 5 and 10 years of HCT, respectively. 10-year non-relapse mortality was 32.5%, and 48.8% of patients showed disease relapse within 10 years after allogeneic HCT. Adverse molecular risk features determined at initial diagnosis, poor performance status at the time of allogeneic HCT, and long diagnosis-to-HCT intervals were associated with unfavorable prognosis. Collectively, our data suggests that immediate allogeneic HCT after PIF offers long-term survival and cure in a substantial subset of cases and that high-risk AML patients who never achieved complete response during induction might benefit from early donor search.
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Affiliation(s)
- Miriam Mozaffari Jovein
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gabriele Ihorst
- Clinical Trials Unit, Biometry and Statistics, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jesús Duque-Afonso
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ralph Wäsch
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Hartmut Bertz
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Claudia Wehr
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Justus Duyster
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Robert Zeiser
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jürgen Finke
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Florian Scherer
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
- German Cancer Consortium (DKTK) partner site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany.
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13
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Lundeen M, Hurd JL, Hayes M, Hayes M, Facile TR, Furia JP, Maffulli N, Alt C, Alt EU, Schmitz C, Pearce DA. Management of partial-thickness rotator cuff tears with autologous adipose-derived regenerative cells is safe and more effective than injection of corticosteroid. Sci Rep 2023; 13:19348. [PMID: 37935850 PMCID: PMC10630470 DOI: 10.1038/s41598-023-46653-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/03/2023] [Indexed: 11/09/2023] Open
Abstract
Symptomatic, partial-thickness rotator cuff tears (sPTRCT) are problematic. This study tested the hypothesis that management of sPTRCT with injection of fresh, uncultured, unmodified, autologous, adipose-derived regenerative cells (UA-ADRCs) is safe and more effective than injection of corticosteroid even in the long run. To this end, subjects who had completed a former randomized controlled trial were enrolled in the present study. At baseline these subjects had not responded to physical therapy treatments for at least 6 weeks, and were randomly assigned to receive respectively a single injection of UA-ADRCs (n = 11) or a single injection of methylprednisolone (n = 5). Efficacy was assessed using the ASES Total score, pain visual analogue scale (VAS), RAND Short Form-36 Health Survey and range of motion at 33.2 ± 1.0 (mean ± SD) and 40.6 ± 1.9 months post-treatment. Proton density, fat-saturated, T2-weighted MRI of the index shoulder was performed at both study visits. There were no greater risks connected with injection of UA-ADRCs than those connected with injection of corticosteroid. The subjects in the UA-ADRCs group showed statistically significantly higher mean ASES Total scores than the subjects in the corticosteroid group. The MRI scans at 6 months post-treatment allowed to "watch the UA-ADRCs at work".
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Affiliation(s)
- Mark Lundeen
- Sanford Orthopedics and Sports Medicine Fargo, Fargo, ND, USA
| | - Jason L Hurd
- Sanford Orthopedics and Sports Medicine Sioux Falls, Sioux Falls, SD, USA
| | | | | | | | - John P Furia
- SUN Orthopedics of Evangelical Community Hospital, Lewisburg, PA, USA
| | - Nicola Maffulli
- Department of Trauma and Orthopaedic Surgery, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
- Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, London, UK
- School of Pharmacy and Bioengineering, Guy Hilton Research Centre, Keele University School of Medicine, Stoke on Trent, UK
| | - Christopher Alt
- InGeneron, Inc., Houston, TX, USA
- Institute of Anatomy, Faculty of Medicine, LMU Munich, Munich, Germany
- Isar Klinikum, Munich, Germany
| | - Eckhard U Alt
- InGeneron, Inc., Houston, TX, USA
- Isar Klinikum, Munich, Germany
- Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA
- Heart and Vascular Institute, Department of Medicine, Tulane University Health Science Center, New Orleans, LA, USA
| | - Christoph Schmitz
- Institute of Anatomy, Faculty of Medicine, LMU Munich, Munich, Germany
| | - David A Pearce
- Sanford Health, Sioux Falls, SD, USA.
- Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA.
- Sanford Research, Sioux Falls, SD, USA.
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14
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Tilmont R, Yakoub-Agha I, Eikema DJ, Zinger N, Haenel M, Schaap N, Arroyo CH, Schuermans C, Besemer B, Engelhardt M, Kuball J, Michieli M, Schub N, Wilson KMO, Bourhis JH, Mateos MV, Rabin N, Jost E, Kröger N, Moraleda JM, Za T, Hayden PJ, Beksac M, Mclornan D, Schönland S, Manier S. Carfilzomib, lenalidomide and dexamethasone followed by a second ASCT is an effective strategy in first relapse multiple myeloma: a study on behalf of the Chronic malignancies working party of the EBMT. Bone Marrow Transplant 2023; 58:1182-1188. [PMID: 37543712 PMCID: PMC10622318 DOI: 10.1038/s41409-023-02048-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 06/30/2023] [Accepted: 07/17/2023] [Indexed: 08/07/2023]
Abstract
In the setting of a first relapse of multiple myeloma (MM), a second autologous stem cell transplant (ASCT) following carfilzomib-lenalidomide-dexamethasone (KRd) is an option, although there is scarce data concerning this approach. We performed a retrospective study involving 22 EBMT-affiliated centers. Eligible MM patients had received a second-line treatment with KRd induction followed by a second ASCT between 2016 and 2018. Primary objective was to estimate progression-free survival (PFS) and overall survival (OS). Secondary objectives were to assess the response rate and identify significant variables affecting PFS and OS. Fifty-one patients were identified, with a median age of 62 years. Median PFS after ASCT was 29.5 months while 24- and 36-months OS rates were 92.1% and 84.5%, respectively. Variables affecting PFS were an interval over four years between transplants and the achievement of a very good partial response (VGPR) or better before the relapse ASCT. Our study suggests that a relapse treatment with ASCT after KRd induction is an effective strategy for patients with a lenalidomide-sensitive first relapse. Patients with at least four years of remission after a frontline ASCT and who achieved at least a VGPR after KRd induction appear to benefit the most from this approach.
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Affiliation(s)
- Rémi Tilmont
- Hematologie Clinique, CHU de Lille, Lille, France
| | - Ibrahim Yakoub-Agha
- Hematologie Clinique, CHU de Lille, Lille, France
- CHU de Lille, Univ Lille, INSERM U1286, Infinite, Lille, France
| | | | | | | | - Nicolaas Schaap
- Radboud University, Medical Centre Nijmegen, Nijmegen, Netherlands
| | | | | | | | | | | | | | - Natalie Schub
- University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | | | | | - Neil Rabin
- University College London Hospital, London, UK
| | - Edgar Jost
- University Hospital Aachen, Aachen, Germany
| | | | | | - Tommaso Za
- Section of Hematology, Catholic University, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Patrick J Hayden
- Department of Haematology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Meral Beksac
- Ankara University Faculty of Medicine, Ankara, Turkey
| | - Donal Mclornan
- University College London Hospitals NHS Trust, Heidelberg, Germany
| | - Stefan Schönland
- Medizinische Klinik u. Poliklinik V, University of Heidelberg, Heidelberg, Germany
| | - Salomon Manier
- Hematologie Clinique, CHU de Lille, Lille, France.
- Univ Lille, Canther, INSERM UMR-S1277 CNRS UMR9020, Lille, France.
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15
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Abstract
Macrophages are essential innate immune cells found throughout the body that have protective and pathogenic functions in many diseases. When activated, macrophages can mediate the phagocytosis of dangerous cells or materials and participate in effective tissue regeneration by providing growth factors and anti-inflammatory molecules. Ex vivo-generated macrophages have thus been used in clinical trials as cell-based therapies, and based on their intrinsic characteristics, they outperformed stem cells within specific target diseases. In addition to the old methods of generating naïve or M2 primed macrophages, the recently developed chimeric antigen receptor-macrophages revealed the potential of genetically engineered macrophages for cell therapy. Here, we review the current developmental status of macrophage-based cell therapy. The findings of important clinical and preclinical trials are updated, and patent status is investigated. Additionally, we discuss the limitations and future directions of macrophage-based cell therapy, which will help broaden the potential utility and clinical applications of macrophages.
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Affiliation(s)
- Yi Rang Na
- Translational Immunology Laboratory, Department of Transdisciplinary Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Sang Wha Kim
- Macrophage Laboratory, Department of Microbiology and Immunology, and Institute of Endemic Disease, Seoul National University College of Medicine, Seoul, 110-799, South Korea
| | - Seung Hyeok Seok
- Macrophage Laboratory, Department of Microbiology and Immunology, and Institute of Endemic Disease, Seoul National University College of Medicine, Seoul, 110-799, South Korea.
- Department of Biomedical Sciences and Seoul National University College of Medicine, Seoul, Republic of Korea.
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
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16
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Pruitt A, Gao F, De Togni E, Cochran H, Godbole S, Slade M, Abboud R. Impact of donor age and relationship on outcomes of peripheral blood haploidentical hematopoietic cell transplantation. Bone Marrow Transplant 2023; 58:855-862. [PMID: 37117266 PMCID: PMC10400423 DOI: 10.1038/s41409-023-01984-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 04/30/2023]
Abstract
Here we describe a retrospective analysis of outcomes in 299 patients who underwent peripheral blood haplo-HCT with PTCy from July 2009 through May 2021 and their association with donor characteristics. Patients had mostly acute leukemias and high or very high DRI. Multivariate analyses were conducted examining OS, NRM, relapse, cytokine release syndrome, acute and chronic GVHD. Donor characteristics included age, sex, relationship, ABO status, CMV status, and HLA match grade. Our analysis revealed increasing donor age was associated with higher NRM (compared to age <30; age 30-44 HR, 1.65; P = 0.110, age >44 HR, 1.80; P = 0.056) but lower relapse risk (compared to age <30; age 30-44 HR, 0.61; P = 0.034, age > 44 HR, 0.71; P = 0.132). There were no differences in CRS, aGVHD or cGVHD. We found no difference in outcomes based on the donor-recipient relationship. No differences were found based on HLA match grade or DRB1 match status. Increasing donor age was associated with lower relapse risk but higher NRM, resulting in no difference in OS based on donor age. Other donor factors including relationship (parent/sibling/child/ maternal), CMV status, donor sex, HLA match grade, and DRB1 status were not associated with outcomes.
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Affiliation(s)
- Aaron Pruitt
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Feng Gao
- Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Elisa De Togni
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Hunter Cochran
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Sonia Godbole
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael Slade
- Division of Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Ramzi Abboud
- Division of Oncology, Washington University School of Medicine, St. Louis, MO, USA.
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17
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Hirschbühl K, Labopin M, Polge E, Blaise D, Bourhis JH, Socié G, Forcade E, Yakoub-Agha I, Labussière-Wallet H, Bethge W, Chevallier P, Bonnet S, Stelljes M, Spyridonidis A, Peric Z, Brissot E, Savani B, Giebel S, Schmid C, Ciceri F, Nagler A, Mohty M. Total body irradiation versus busulfan based intermediate intensity conditioning for stem cell transplantation in ALL patients >45 years-a registry-based study by the Acute Leukemia Working Party of the EBMT. Bone Marrow Transplant 2023; 58:874-880. [PMID: 37147469 PMCID: PMC10400409 DOI: 10.1038/s41409-023-01966-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/12/2023] [Accepted: 03/17/2023] [Indexed: 05/07/2023]
Abstract
Allogeneic hematopoietic cell transplantation is a potentially curative treatment in high-risk acute lymphoblastic leukemia (ALL). Conditioning regimens based on ≥12 Gray total body irradiation (TBI) represent the current standard in patients ≤45 years, whereas elderly patients frequently receive intermediate intensity conditioning (IIC) to reduce toxicity. To evaluate the role of TBI as a backbone of IIC in ALL, a retrospective, registry-based study included patients >45 years transplanted from matched donors in first complete remission, who had received either fludarabine/TBI 8 Gy (FluTBI8, n = 262), or the most popular, irradiation-free alternative fludarabine/busulfan, comprising busulfan 6.4 mg/kg (FluBu6.4, n = 188) or 9.6 mg/kg (FluBu9.6, n = 51). At two years, overall survival (OS) was 68.5%, 57%, and 62.2%, leukemia-free survival (LFS) was 58%, 42.7%, and 45%, relapse incidence (RI) was 27.2%, 40%, and 30.9%, and non-relapse-mortality (NRM) was 23.1%, 20.7%, and 26.8% for patients receiving FluTBI8Gy, FluBu6.4, and FluBu9.6, respectively. In multivariate analysis, the risk of NRM, acute and chronic graft-versus-host disease was not influenced by conditioning. However, RI was higher after FluBu6.4 (hazard ratio [HR] [95% CI]: 1.85 [1.16-2.95]), and LFS was lower after both FluBu6.4 (HR: 1.56 [1.09-2.23]) and FluBu9.6 (HR: 1.63 [1.02-2.58]) as compared to FluTBI8. Although only resulting in a non-significant advantage in OS, this observation indicates a stronger anti-leukemic efficacy of TBI-based intermediate intensity conditioning.
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Affiliation(s)
- Klaus Hirschbühl
- Augsburg University Hospital and Medical Faculty, Augsburg, Germany
| | - Myriam Labopin
- EBMT Statistical Unit, Sorbonne Université, INSERM UMR-S 938, CRSA, Service d'hématologie et Thérapie Cellulaire, AP-HP, Hôpital Saint-Antoine, 75 012, Paris, France
| | - Emmanuelle Polge
- EBMT Statistical Unit, Sorbonne Université, INSERM UMR-S 938, CRSA, Service d'hématologie et Thérapie Cellulaire, AP-HP, Hôpital Saint-Antoine, 75 012, Paris, France
| | - Didier Blaise
- Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France
| | - Jean Henri Bourhis
- Department of Hematology, Gustave Roussy Cancer Campus BMT Service, Villejuif, France
| | - Gerard Socié
- Department of Hematology - BMT, Hopital St. Louis, Paris, France
| | | | | | | | - Wolfgang Bethge
- Universitaet Tuebingen, Medizinische Klinik, Abteilung II, Tuebingen, Germany
| | | | - Sarah Bonnet
- Département d'Hématologie Clinique, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Matthias Stelljes
- Department of Medicine A-Hematology, Hemostaseology, Oncology, Pulmonology, University Hospital Muenster, 48149, Munster, Germany
| | - Alexandros Spyridonidis
- Department of Internal Medicine, BMT Unit and CBMDP Donor Center, University of Patras, Patras, Greece
| | - Zinaida Peric
- Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Eolia Brissot
- APHP, Hôpital Saint Antoine, Service d'Hématologie Clinique et de Thérapie Cellulaire, Paris, France
| | - Bipin Savani
- Division of Hematology and Oncology, Vanderbilt University, Nashville, TN, USA
| | - Sebastian Giebel
- Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Christoph Schmid
- Augsburg University Hospital and Medical Faculty, Augsburg, Germany.
| | - Fabio Ciceri
- IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Arnon Nagler
- Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Mohamad Mohty
- EBMT Statistical Unit, Sorbonne Université, INSERM UMR-S 938, CRSA, Service d'hématologie et Thérapie Cellulaire, AP-HP, Hôpital Saint-Antoine, 75 012, Paris, France
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18
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Filippini Velázquez G, Labopin M, Tischer J, Raiola AM, Angelucci E, Kulagin AD, Galieni P, Bermúdez A, Bulabois CE, Kröger N, Díez-Martín JL, Kwon M, Nagler A, Schmid C, Ciceri F, Mohty M. Second haploidentical stem cell transplantation (HAPLO-SCT2) after relapse from a first HAPLO-SCT in acute leukaemia-a study on behalf of the Acute Leukaemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant 2023; 58:907-915. [PMID: 37160941 PMCID: PMC10400422 DOI: 10.1038/s41409-023-01985-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 03/20/2023] [Accepted: 04/04/2023] [Indexed: 05/11/2023]
Abstract
For patients with acute myeloid and lymphoblastic leukaemia (AML/ALL) lacking a matched sibling or unrelated donor, haploidentical stem cell transplantation (HAPLO-SCT) is increasingly used. However, available data on the treatment of relapse after HAPLO-SCT, including feasibility and efficacy of a second HAPLO-SCT (HAPLO-SCT2), is scarce. Hence, adults with AML/ALL, that had undergone HAPLO-SCT2 without ex-vivo manipulation after haematologic relapse from HAPLO-SCT1 were selected for a retrospective registry analysis. Eighty-two patients (AML, n = 63, ALL, n = 19, median follow-up: 33 months) were identified. Engraftment rate was 87%. At day +180, cumulative incidences of acute GvHD II-IV°/chronic GvHD were 23.9%/22.6%, respectively. Two-year overall survival/leukaemia-free survival (OS/LFS) were 34.3%/25.4%; 2-year non-relapse mortality (NRM) and relapse incidence (RI) were 17.6% and 57%. Leukaemia was the most frequent cause of death. Separated by disease, 2-year OS/LFS/NRM/RI were 28.7%/22.3%/16.2%/61.6% in AML, and 55.3%/38.4%/23.5%/38.2% in ALL patients. In a risk-factor analysis among patients with AML, stage at HAPLO-SCT1 and HAPLO-SCT2, and interval from HAPLO-SCT1 to relapse significantly influenced outcome. Our data demonstrate that HAPLO-SCT2 is a viable option in acute leukaemia relapse after HAPLO-SCT1. Engraftment, toxicity, risk factors and long-term outcome are comparable to data reported after allo-SCT2 in a matched donor setting.
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Affiliation(s)
| | - Myriam Labopin
- EBMT Paris Study Unit, Saint-Antoine Hospital, Paris, France
- Department of Haematology, Hôpital Saint-Antoine, Sorbonne University, INSERM UMRs 938, Paris, France
| | - Johanna Tischer
- Department of Internal Medicine III, University Hospital of Munich, Campus Grosshadern, Munich, Germany
| | - Anna Maria Raiola
- Hematology and cellular therapy unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Emanuele Angelucci
- Hematology and cellular therapy unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Alexander D Kulagin
- RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russian Federation
| | - Piero Galieni
- Haematology Service, Mazzoni Hospital, Ascoli Piceno, Italy
| | - Arancha Bermúdez
- Servicio de Hematología-Hemoterapia, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Claude-Eric Bulabois
- Service d'Hématologie, CHU Grenoble Alpes-Université Grenoble Alpes, Grenoble, France
| | - Nicolaus Kröger
- University Medical Center Hamburg-Eppendorf, Department of Stem Cell Transplantation, Hamburg, Germany
| | | | - Mi Kwon
- Sección de Trasplante de Médula Ósea, Hospital Gregorio Marañón, Madrid, Spain
| | - Arnon Nagler
- Hematology and Bone Marrow Transplant Unit, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Christoph Schmid
- Section for Stem Cell Transplantation, Augsburg University Hospital and Medical Faculty, Augsburg, Germany.
| | - Fabio Ciceri
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Mohamad Mohty
- Department of Haematology, Hôpital Saint-Antoine, Sorbonne University, INSERM UMRs 938, Paris, France
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19
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Nijssen K, Westinga K, Stuut A, Janssen A, van Rhenen A, van der Wagen L, Daenen LGM, Oostvogels R, de Witte MA, Kuball J. Graft engineering: how long can you wait, how low can you go, and pandemic readiness. Bone Marrow Transplant 2023; 58:820-822. [PMID: 37012417 PMCID: PMC10069722 DOI: 10.1038/s41409-023-01976-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 04/05/2023]
Affiliation(s)
- Klaartje Nijssen
- Department of Hematology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Kasper Westinga
- Cell Therapy Facility, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Anniek Stuut
- Center for Translational Immunology, Utrecht, the Netherlands
| | - Anke Janssen
- Department of Hematology, University Medical Center Utrecht, Utrecht, the Netherlands
- Center for Translational Immunology, Utrecht, the Netherlands
| | - Anna van Rhenen
- Department of Hematology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Lotte van der Wagen
- Department of Hematology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Laura G M Daenen
- Department of Hematology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rimke Oostvogels
- Department of Hematology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Moniek A de Witte
- Department of Hematology, University Medical Center Utrecht, Utrecht, the Netherlands
- Center for Translational Immunology, Utrecht, the Netherlands
| | - Jürgen Kuball
- Department of Hematology, University Medical Center Utrecht, Utrecht, the Netherlands.
- Center for Translational Immunology, Utrecht, the Netherlands.
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20
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Marinkovic M, Tran ON, Wang H, Abdul-Azees P, Dean DD, Chen XD, Yeh CK. Autologous mesenchymal stem cells offer a new paradigm for salivary gland regeneration. Int J Oral Sci 2023; 15:18. [PMID: 37165024 PMCID: PMC10172302 DOI: 10.1038/s41368-023-00224-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/20/2023] [Accepted: 03/29/2023] [Indexed: 05/12/2023] Open
Abstract
Salivary gland (SG) dysfunction, due to radiotherapy, disease, or aging, is a clinical manifestation that has the potential to cause severe oral and/or systemic diseases and compromise quality of life. Currently, the standard-of-care for this condition remains palliative. A variety of approaches have been employed to restore saliva production, but they have largely failed due to damage to both secretory cells and the extracellular matrix (niche). Transplantation of allogeneic cells from healthy donors has been suggested as a potential solution, but no definitive population of SG stem cells, capable of regenerating the gland, has been identified. Alternatively, mesenchymal stem cells (MSCs) are abundant, well characterized, and during SG development/homeostasis engage in signaling crosstalk with the SG epithelium. Further, the trans-differentiation potential of these cells and their ability to regenerate SG tissues have been demonstrated. However, recent findings suggest that the "immuno-privileged" status of allogeneic adult MSCs may not reflect their status post-transplantation. In contrast, autologous MSCs can be recovered from healthy tissues and do not present a challenge to the recipient's immune system. With recent advances in our ability to expand MSCs in vitro on tissue-specific matrices, autologous MSCs may offer a new therapeutic paradigm for restoration of SG function.
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Affiliation(s)
- Milos Marinkovic
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Research Service, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Olivia N Tran
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Hanzhou Wang
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Parveez Abdul-Azees
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Research Service, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - David D Dean
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, TX, USA
| | - Xiao-Dong Chen
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
- Research Service, South Texas Veterans Health Care System, San Antonio, TX, USA.
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, TX, USA.
| | - Chih-Ko Yeh
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
- Geriatric Research, Education and Clinical Center, South Texas Veterans Health Care System, San Antonio, TX, USA.
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21
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Pope JE, Denton CP, Johnson SR, Fernandez-Codina A, Hudson M, Nevskaya T. State-of-the-art evidence in the treatment of systemic sclerosis. Nat Rev Rheumatol 2023; 19:212-226. [PMID: 36849541 PMCID: PMC9970138 DOI: 10.1038/s41584-023-00909-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2023] [Indexed: 03/01/2023]
Abstract
Systemic sclerosis (SSc) is a rare autoimmune connective tissue disease with multi-organ involvement, fibrosis and vasculopathy. Treatment in SSc, including early diffuse cutaneous SSc (dcSSc) and the use of organ-specific therapies, has improved, as evident from randomized clinical trials. Treatments for early dcSSc include immunosuppressive agents such as mycophenolate mofetil, methotrexate, cyclophosphamide, rituximab and tocilizumab. Patients with rapidly progressive early dcSSc might be eligible for autologous haematopoietic stem cell transplantation, which can improve survival. Morbidity from interstitial lung disease and pulmonary arterial hypertension is improving with the use of proven therapies. Mycophenolate mofetil has surpassed cyclophosphamide as the initial treatment for SSc-interstitial lung disease. Nintedanib and possibly perfinidone can be considered in SSc pulmonary fibrosis. Pulmonary arterial hypertension is frequently treated with initial combination therapy (for example, with phosphodiesterase 5 inhibitors and endothelin receptor antagonists) and, if necessary, the addition of a prostacyclin analogue. Raynaud phenomenon and digital ulcers are treated with dihydropyridine calcium channel blockers (especially nifedipine), then phosphodiesterase 5 inhibitors or intravenous iloprost. Bosentan can reduce the development of new digital ulcers. Trial data for other manifestations are mostly lacking. Research is needed to develop targeted and highly effective treatments, best practices for organ-specific screening and early intervention, and sensitive outcome measurements.
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Affiliation(s)
- Janet E Pope
- Division of Rheumatology, St Joseph's Health Care, London, ON, Canada.
- Department of Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada.
| | | | - Sindhu R Johnson
- Toronto Scleroderma Program, Toronto Western Hospital, Mount Sinai Hospital, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Andreu Fernandez-Codina
- Division of Rheumatology, St Joseph's Health Care, London, ON, Canada
- General Internal Medicine, Windsor Regional Hospital, Windsor, ON, Canada
- Critical Care, Emergency and Systemic Autoimmune Diseases, Hospital Clinic, Barcelona, Spain
| | - Marie Hudson
- Department of Medicine, McGill University, Montreal, QC, Canada
- Division of Rheumatology and Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Tatiana Nevskaya
- Division of Rheumatology, St Joseph's Health Care, London, ON, Canada
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22
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Moiseev I, Ambron P, Badoglio M, Peczynski C, Basak G, Koenecke C, Schoemans H, Penack O, Peric Z. Steroid-free first line treatment of moderate and severe chronic GVHD: a survey from the Transplant Complications Working Party of the EBMT. Bone Marrow Transplant 2023; 58:325-7. [PMID: 36446899 DOI: 10.1038/s41409-022-01881-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022]
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23
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Laberko A, Sultanova E, Idarmacheva A, Skvortsova Y, Shelikhova L, Nechesnyuk A, Kobyzeva D, Shcherbina A, Maschan M, Maschan A, Balashov D. Second allogeneic hematopoietic stem cell transplantation in patients with inborn errors of immunity. Bone Marrow Transplant 2023; 58:273-81. [PMID: 36456809 DOI: 10.1038/s41409-022-01883-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022]
Abstract
Graft failure (GF) remains a serious issue of hematopoietic stem cell transplantation (HSCT) in inborn errors of immunity (IEI). Second HSCT is the only salvage therapy for GF. There are no uniform strategies for the second HSCTs and limited data are available on the second HSCT outcomes. 48 patients with various IEI received second allogeneic HSCT from 2013 to 2020. Different conditioning regimens were used, divided into two main groups: containing myeloablative doses of busulfan/treosulfan (n = 19) and lymphoid irradiation 2-6 Gy (n = 22). Irradiation-containing conditioning was predominantly used in suspected immune-mediated rejection of the first graft. Matched unrelated donor was used in 28 patients, mismatched related in 18, and matched related in 1. 35 patients received TCRαβ/CD19 graft depletion. The median follow-up time was 2.4 years post-HSCT. One patient died at conditioning. The OS was 0.63 (95% CI: 0.41-0.85) after busulfan/treosulfan and 0.68 (95% CI: 0.48-0.88) after irradiation-based conditioning, p = 0.66. Active infection at HSCT significantly influenced OS: 0.43 (95% CI: 0.17-0.69) versus 0.73 (95% CI: 0.58-0.88) without infection, p = 0.004. The cumulative incidence of GF was 0.15 (95% CI: 0.08-0.29). To conclude, an individualized approach is required for the second HSCT in IEI. Low-dose lymphoid irradiation in suspected immune-mediated GF may be a feasible option.
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24
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Backhaus D, Brauer D, Pointner R, Bischof L, Vucinic V, Franke GN, Niederwieser D, Platzbecker U, Jentzsch M, Schwind S. A high hematopoietic cell transplantation comorbidity Index (HCT-CI) does not impair outcomes after non-myeloablative allogeneic stem cell transplantation in acute myeloid leukemia patients 60 years or older. Bone Marrow Transplant 2023; 58:30-38. [PMID: 36195769 PMCID: PMC9812784 DOI: 10.1038/s41409-022-01833-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 01/10/2023]
Abstract
For most acute myeloid leukemia (AML) patients an allogeneic hematopoietic stem cell transplantation (HSCT) offers the highest chance of cure. The introduction of less toxic non-myeloablative conditioning (NMA) regimes enabled older and/or comorbid patients to be consolidated with an allogeneic HSCT. While the hematopoietic cell transplantation comorbidity index (HCT-CI) predicted outcomes in many younger patient cohorts its impact in older AML patients receiving NMA-HSCT remains unknown. Here we analyzed 289 AML patients 60 years or older (median age 66, range 60-77 years) undergoing NMA-HSCT (2 or 3 Gray total body irradiation and 3 days of fludarabine 30 mg/m2). HCT-CI risk was low, intermediate, or high in 36%, 31%, and 33% of patients, respectively. Non-relapse mortality (NRM), cumulative incidence of relapse (CIR), and overall survival (OS) did not differ between HCT-CI groups. The HCT-CI also did not impact outcomes when considering the European LeukemiaNet 2017 risk at diagnosis or the measurable residual disease (MRD) status at HSCT. Notably, MRD-negative older NMA-transplanted AML patients had a beneficial OS of 49% after 5 years. Since a higher HCT-CI did not impair outcomes, age or comorbidities per se should not impede NMA-HSCT, presenting a feasible consolidation option for this group of AML patients.
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Affiliation(s)
- Donata Backhaus
- grid.9647.c0000 0004 7669 9786Medical Clinic and Policlinic 1, Hematology, Cellular Therapy and Hemostaseology; University of Leipzig Medical Center, Leipzig, Germany
| | - Dominic Brauer
- grid.9647.c0000 0004 7669 9786Medical Clinic and Policlinic 1, Hematology, Cellular Therapy and Hemostaseology; University of Leipzig Medical Center, Leipzig, Germany
| | - Rosmarie Pointner
- grid.9647.c0000 0004 7669 9786Medical Clinic and Policlinic 1, Hematology, Cellular Therapy and Hemostaseology; University of Leipzig Medical Center, Leipzig, Germany
| | - Lara Bischof
- grid.9647.c0000 0004 7669 9786Medical Clinic and Policlinic 1, Hematology, Cellular Therapy and Hemostaseology; University of Leipzig Medical Center, Leipzig, Germany
| | - Vladan Vucinic
- grid.9647.c0000 0004 7669 9786Medical Clinic and Policlinic 1, Hematology, Cellular Therapy and Hemostaseology; University of Leipzig Medical Center, Leipzig, Germany
| | - Georg-Nikolaus Franke
- grid.9647.c0000 0004 7669 9786Medical Clinic and Policlinic 1, Hematology, Cellular Therapy and Hemostaseology; University of Leipzig Medical Center, Leipzig, Germany
| | - Dietger Niederwieser
- grid.9647.c0000 0004 7669 9786Medical Clinic and Policlinic 1, Hematology, Cellular Therapy and Hemostaseology; University of Leipzig Medical Center, Leipzig, Germany
| | - Uwe Platzbecker
- grid.9647.c0000 0004 7669 9786Medical Clinic and Policlinic 1, Hematology, Cellular Therapy and Hemostaseology; University of Leipzig Medical Center, Leipzig, Germany
| | - Madlen Jentzsch
- grid.9647.c0000 0004 7669 9786Medical Clinic and Policlinic 1, Hematology, Cellular Therapy and Hemostaseology; University of Leipzig Medical Center, Leipzig, Germany
| | - Sebastian Schwind
- Medical Clinic and Policlinic 1, Hematology, Cellular Therapy and Hemostaseology; University of Leipzig Medical Center, Leipzig, Germany.
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25
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Nadiminti K, Langer K, Shabbir E, Hefazi M, Dozeman L, Jethava Y, Loeffler B, AlKhateeb HB, Litzow M, Patnaik M, Shah M, Hogan W, Farooq U, Silverman M, Mott SL. A novel Iowa-Mayo validated composite risk assessment tool for allogeneic stem cell transplantation survival outcome prediction. Blood Cancer J 2021; 11:183. [PMID: 34802042 DOI: 10.1038/s41408-021-00573-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/05/2021] [Accepted: 10/27/2021] [Indexed: 11/09/2022] Open
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative option for many hematologic conditions and is associated with considerable morbidity and mortality. Therefore, prognostic tools are essential to navigate the complex patient, disease, donor, and transplant characteristics that differentially influence outcomes. We developed a novel, comprehensive composite prognostic tool. Using a lasso-penalized Cox regression model (n = 273), performance status, HCT-CI, refined disease-risk index (rDRI), donor and recipient CMV status, and donor age were identified as predictors of disease-free survival (DFS). The results for overall survival (OS) were similar except for recipient CMV status not being included in the model. Models were validated in an external dataset (n = 378) and resulted in a c-statistic of 0.61 and 0.62 for DFS and OS, respectively. Importantly, this tool incorporates donor age as a variable, which has an important role in HSCT outcomes. This needs to be further studied in prospective models. An easy-to-use and a web-based nomogram can be accessed here: https://allohsctsurvivalcalc.iowa.uiowa.edu/ .
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26
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Zanirati G, Provenzi L, Libermann LL, Bizotto SC, Ghilardi IM, Marinowic DR, Shetty AK, Da Costa JC. Stem cell-based therapy for COVID-19 and ARDS: a systematic review. NPJ Regen Med 2021; 6:73. [PMID: 34750382 DOI: 10.1038/s41536-021-00181-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/29/2021] [Indexed: 12/29/2022] Open
Abstract
Despite global efforts to establish effective interventions for coronavirus disease 2019 (COVID-19) and its major complications, such as acute respiratory distress syndrome (ARDS), the treatment remains mainly supportive. Hence, identifying an effective and safe therapy for severe COVID-19 is critical for saving lives. A significant number of cell-based therapies have been through clinical investigation. In this study, we performed a systematic review of clinical studies investigating different types of stem cells as treatments for COVID-19 and ARDS to evaluate the safety and potential efficacy of cell therapy. The literature search was performed using PubMed, Embase, and Scopus. Among the 29 studies, there were eight case reports, five Phase I clinical trials, four pilot studies, two Phase II clinical trials, one cohort, and one case series. Among the clinical studies, 21 studies used cell therapy to treat COVID-19, while eight studies investigated cell therapy as a treatment for ARDS. Most of these (75%) used mesenchymal stem cells (MSCs) to treat COVID-19 and ARDS. Findings from the analyzed articles indicate a positive impact of stem cell therapy on crucial immunological and inflammatory processes that lead to lung injury in COVID-19 and ARDS patients. Additionally, among the studies, there were no reported deaths causally linked to cell therapy. In addition to standard care treatments concerning COVID-19 management, there has been supportive evidence towards adjuvant therapies to reduce mortality rates and improve recovery of care treatment. Therefore, MSCs treatment could be considered a potential candidate for adjuvant therapy in moderate-to-severe COVID-19 cases and compassionate use.
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27
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Park JH, Kim H, Moon HR, Park BW, Park JH, Sim WS, Kim JJ, Lim HJ, Kim YJ, Ji ST, Jang WB, Rethineswaran VK, Van LTH, Giang LTT, Yun J, Ha JS, Ban K, Chung HY, Baek SH, Park HJ, Kwon SM. Human cardiac stem cells rejuvenated by modulating autophagy with MHY-1685 enhance the therapeutic potential for cardiac repair. Exp Mol Med 2021; 53:1423-36. [PMID: 34584195 DOI: 10.1038/s12276-021-00676-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/27/2021] [Accepted: 07/06/2021] [Indexed: 02/08/2023] Open
Abstract
Stem cell-based therapies with clinical applications require millions of cells. Therefore, repeated subculture is essential for cellular expansion, which is often complicated by replicative senescence. Cellular senescence contributes to reduced stem cell regenerative potential as it inhibits stem cell proliferation and differentiation as well as the activation of the senescence-associated secretory phenotype (SASP). In this study, we employed MHY-1685, a novel mammalian target of rapamycin (mTOR) inhibitor, and examined its long-term priming effect on the activities of senile human cardiac stem cells (hCSCs) and the functional benefits of primed hCSCs after transplantation. In vitro experiments showed that the MHY-1685‒primed hCSCs exhibited higher viability in response to oxidative stress and an enhanced proliferation potential compared to that of the unprimed senile hCSCs. Interestingly, priming MHY-1685 enhanced the expression of stemness-related markers in senile hCSCs and provided the differentiation potential of hCSCs into vascular lineages. In vivo experiment with echocardiography showed that transplantation of MHY-1685‒primed hCSCs improved cardiac function than that of the unprimed senile hCSCs at 4 weeks post-MI. In addition, hearts transplanted with MHY-1685-primed hCSCs exhibited significantly lower cardiac fibrosis and higher capillary density than that of the unprimed senile hCSCs. In confocal fluorescence imaging, MHY-1685‒primed hCSCs survived for longer durations than that of the unprimed senile hCSCs and had a higher potential to differentiate into endothelial cells (ECs) within the infarcted hearts. These findings suggest that MHY-1685 can rejuvenate senile hCSCs by modulating autophagy and that as a senescence inhibitor, MHY-1685 can provide opportunities to improve hCSC-based myocardial regeneration.
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28
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Nagano H, Suematsu Y, Takuma M, Aoki S, Satoh A, Takayama E, Kinoshita M, Morimoto Y, Takeoka S, Fujie T, Kiyosawa T. Enhanced cellular engraftment of adipose-derived mesenchymal stem cell spheroids by using nanosheets as scaffolds. Sci Rep 2021; 11:14500. [PMID: 34262089 PMCID: PMC8280158 DOI: 10.1038/s41598-021-93642-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 06/28/2021] [Indexed: 02/07/2023] Open
Abstract
The short survival time of transplanted adipose-derived mesenchymal stem cells (ASCs) is a problem for skin wound healing. Transplantation after the formation of cellular spheroids has been investigated as a promising method for prolonging cellular survival. However, there have been technical restrictions for transplantation of spheroids in clinical practice. Here, we show an effective method for transplantation of ASC spheroids onto skin wounds in order to efficiently cure refractory ulcers. To assist anchoring of spheroids onto skin wounds, we used a 120-nm-thick free-standing film (nanosheet) that has a highly adhesive property. Bioluminescence imaging showed that ASC spheroids carried by the nanosheet survived for 14 days, which is about two-times longer than that previously reported. Wounds treated with a nanosheet carrying ASC spheroids were 4-times smaller than untreated wounds on day 14. This method for transplantation of spheroids could be applied to cell therapy for various refractory skin wounds.
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Affiliation(s)
- Hisato Nagano
- Department of Plastic and Reconstructive Surgery, National Defense Medical College, Tokorozawa, Saitama, 359-8513, Japan
| | - Yoshitaka Suematsu
- Department of Life Science and Medical Bioscience, Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, 162-8480, Japan
| | - Megumi Takuma
- School of Life Science and Technology, Tokyo Institute of Technology, Yokohama, Kanagawa, 226-8501, Japan
| | - Shimpo Aoki
- Tissue Engineering and Wound Healing Laboratory, Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Ayano Satoh
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, 700-0082, Japan
| | - Eiji Takayama
- Department of Oral Biochemistry, Asahi University School of Dentistry, Gifu, 501-0296, Japan
| | - Manabu Kinoshita
- Department of Immunology and Microbiology, National Defense Medical College, Tokorozawa, Saitama, 359-8513, Japan
| | - Yuji Morimoto
- Department of Physiology, National Defense Medical College, Tokorozawa, Saitama, 359-8513, Japan
| | - Shinji Takeoka
- Institute for Advanced Research of Biosystem Dynamics, Research Institute for Science and Engineering, Waseda University, 3-4-1 Ohkubo, Shinjuku-ku, Tokyo, 169-8555, Japan
| | - Toshinori Fujie
- School of Life Science and Technology, Tokyo Institute of Technology, Yokohama, Kanagawa, 226-8501, Japan
| | - Tomoharu Kiyosawa
- Department of Plastic and Reconstructive Surgery, National Defense Medical College, Tokorozawa, Saitama, 359-8513, Japan.
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Waters SL, Schumacher LJ, El Haj AJ. Regenerative medicine meets mathematical modelling: developing symbiotic relationships. NPJ Regen Med 2021; 6:24. [PMID: 33846347 PMCID: PMC8042047 DOI: 10.1038/s41536-021-00134-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 02/26/2021] [Indexed: 02/01/2023] Open
Abstract
Successful progression from bench to bedside for regenerative medicine products is challenging and requires a multidisciplinary approach. What has not yet been fully recognised is the potential for quantitative data analysis and mathematical modelling approaches to support this process. In this review, we highlight the wealth of opportunities for embedding mathematical and computational approaches within all stages of the regenerative medicine pipeline. We explore how exploiting quantitative mathematical and computational approaches, alongside state-of-the-art regenerative medicine research, can lead to therapies that potentially can be more rapidly translated into the clinic.
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Affiliation(s)
- S L Waters
- Oxford Centre for Industrial and Applied Mathematics, Mathematical Institute, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK
| | - L J Schumacher
- Centre for Regenerative Medicine, The University of Edinburgh, Edinburgh BioQuarter, Edinburgh, UK
| | - A J El Haj
- Healthcare Technology Institute, Institute of Translational Medicine, School of Chemical Engineering, University of Birmingham, Birmingham, UK.
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Colunga-Pedraza PR, Colunga-Pedraza JE, Meléndez-Flores JD, González-Treviño M, Ramos-Dávila EM, Gómez-De León A, Peña-Lozano SP, González-Llano Ó, Cantú-Rodríguez OG, Bustillos-Muñoz M, Gutiérrez-Aguirre CH, Gómez-Almaguer D, Jaime-Pérez JC. Outpatient transplantation in the COVID-19 era: a single-center Latin American experience. Bone Marrow Transplant 2021; 56:2287-90. [PMID: 34045692 DOI: 10.1038/s41409-021-01360-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/06/2021] [Accepted: 05/17/2021] [Indexed: 02/05/2023]
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Karnas E, Sekuła-Stryjewska M, Kmiotek-Wasylewska K, Bobis-Wozowicz S, Ryszawy D, Sarna M, Madeja Z, Zuba-Surma EK. Extracellular vesicles from human iPSCs enhance reconstitution capacity of cord blood-derived hematopoietic stem and progenitor cells. Leukemia 2021; 35:2964-2977. [PMID: 34140648 PMCID: PMC8478657 DOI: 10.1038/s41375-021-01325-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/01/2021] [Accepted: 06/07/2021] [Indexed: 02/06/2023]
Abstract
Cord blood (CB) represents a source of hematopoietic stem and progenitor cells (CB-HSPCs) for bone marrow (BM) reconstitution, but clinical CB application is limited in adult patients due to the insufficient number of CB-HSCPCs and the lack of effective ex vivo approaches to increase CB-HSPC functionality. Since human-induced pluripotent stem cells (hiPSCs) have been indicated as donor cells for bioactive extracellular vesicles (EVs) modulating properties of other cells, we are the first to employ hiPSC-derived EVs (hiPSC-EVs) to enhance the hematopoietic potential of CB-derived CD45dimLin-CD34+ cell fraction enriched in CB-HSPCs. We demonstrated that hiPSC-EVs improved functional properties of CB-HSPCs critical for their hematopoietic capacity including metabolic, hematopoietic and clonogenic potential as well as survival, chemotactic response to stromal cell-derived factor 1 and adhesion to the model components of hematopoietic niche in vitro. Moreover, hiPSC-EVs enhanced homing and engraftment of CB-HSPCs in vivo. This phenomenon might be related to activation of signaling pathways in CB-HSPCs following hiPSC-EV treatment, as shown on both gene expression and the protein kinases activity levels. In conclusion, hiPSC-EVs might be used as ex vivo modulators of CB-HSPCs capacity to enhance their functional properties and augment future practical applications of CB-derived cells in BM reconstitution.
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Affiliation(s)
- Elżbieta Karnas
- grid.5522.00000 0001 2162 9631Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Małgorzata Sekuła-Stryjewska
- grid.5522.00000 0001 2162 9631Laboratory of Stem Cell Biotechnology, Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
| | - Katarzyna Kmiotek-Wasylewska
- grid.5522.00000 0001 2162 9631Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Sylwia Bobis-Wozowicz
- grid.5522.00000 0001 2162 9631Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Damian Ryszawy
- grid.5522.00000 0001 2162 9631Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Michał Sarna
- grid.5522.00000 0001 2162 9631Department of Biophysics, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Zbigniew Madeja
- grid.5522.00000 0001 2162 9631Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Ewa K. Zuba-Surma
- grid.5522.00000 0001 2162 9631Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
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Li SC, Sparks KJ, Sender LS. Implementation and Validation of the Roche Light Cycler 480 96-Well Plate Platform as a Real-Time PCR Assay for the Quantitative Detection of Cytomegalovirus (CMV) in Clinical Specimens Using the Luminex MultiCode ASRs System. Med Sci (Basel) 2020; 8:E14. [PMID: 32168800 DOI: 10.3390/medsci8010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/03/2020] [Accepted: 03/07/2020] [Indexed: 11/16/2022] Open
Abstract
Allogenic stem-cell therapies benefit patients in the treatment of multiple diseases; however, the side effects of stem-cell therapies (SCT) derived from the concomitant use of immune suppression agents often include triggering infection diseases. Thus, analysis is required to improve the detection of pathogen infections in SCT. We develop a polymerase chain reaction (PCR)-based methodology for the qualitative real-time DNA detection of cytomegalovirus (CMV), with reference to herpes simplex virus types 1 (HSVI), Epstein–Barr virus (EBV), and varicella-zoster virus (VZV) in blood, urine, solid tissues, and cerebrospinal fluid. This real-time PCR of 96-well plate format provides a rapid framework as required by the Food and Drug Administration (FDA) for clinical settings, including the processing of specimens, reagent handling, special safety precautions, quality control criteria and analytical accuracy, precisely reportable range (analyst measurement range), reference range, limit of detection (LOD), analytical specificity established by interference study, and analyte stability. Specifically, we determined the reportable range (analyst measurement range) with the following criteria: CMV copies ≥200 copies/mL; report copy/mL value; CMV copies ≤199 copies/mL; report detected but below quantitative range; CMV copies = 0 with report <200 copies/mL. That is, with reference range, copy numbers (CN) per milliliter (mL) of the LOD were determined by standard curves that correlated Ct value and calibrated standard DNA panels. The three repeats determined that the measuring range was 1E2~1E6 copies/mL. The standard curves show the slopes were within the range −2.99 to −3.65 with R2 ≥ 0.98. High copy (HC) controls were within 0.17–0.18 log differences of DNA copy numbers; (2) low copy (LC) controls were within 0.17–0.18 log differences; (3) LOD was within 0.14–0.15 log differences. As such, we set up a fast, simple, inexpensive, sensitive, and reliable molecular approach for the qualitative detection of CMV pathogens. Conclusion: This real-time PCR of the 96-well plate format provides a rapid framework as required by the FDA for clinical settings.
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